Provider Demographics
NPI:1710074562
Name:ROSSOS, APOSTOLOS A PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:APOSTOLOS
Middle Name:A PAUL
Last Name:ROSSOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 KUSER ROAD SUITE B-5
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619
Mailing Address - Country:US
Mailing Address - Phone:609-581-0500
Mailing Address - Fax:609-581-2077
Practice Address - Street 1:1542 KUSER ROAD SUITE B-5
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-581-0500
Practice Address - Fax:609-581-2077
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA044558207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3288404Medicaid
NJ050253Medicare ID - Type Unspecified
NJ3288404Medicaid